Individual therapy uses psychodynamic principles with such modifications aslimit-setting and explicit advice or suggestions to help patients addressdifficulties in interpersonal functioning. One approach that has been tested withcocaine- and alcohol-dependent persons is supportive-expressive therapy, whichattempts to create a safe and supportive therapeutic alliance that encourages thepatient to address negative patterns in other relationships (American Psychiatric Association, 1995; National Institute onDrug Abuse, unpublished). This technique is usually used in conjunctionwith more comprehensive treatment efforts and focuses on current life problems,not developmental issues. Some research studies indicate that individualpsychotherapy is most beneficial for opiate-dependent patients with moderatelevels of psychopathology who can form a therapeutic alliance (National Institute on Drug Abuse,unpublished). Drug counseling provided by paraprofessionals focuses onspecific strategies for reducing drug use or pragmatic issues related to treatmentretention or participation (e.g., urine testing results, attendance, and referralfor special services). This differs from psychotherapy by trained mental healthprofessionals (American PsychiatricAssociation, 1995).
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